• Balaji Vaithialingam, Dheeraj Masapu, and Satish Rudrappa.
• Department of Anaesthesia, Sakra world hospital, 560103, Bellandur, Bengaluru, Karnataka, India. balamedicine04@gmail.com.
• J Clin Monit Comput. 2023 Jun 1; 37 (3): 929931929-931.

AbstractThe D-wave reflects the corticospinal fibre potentials and is frequently recorded intraoperatively for intramedullary spinal tumours to ensure maximum safe resection. A 38-year-old male had an intramedullary spinal cord tumour surgically removed while being monitored with D-wave from a single distal electrode technique. Total intravenous anaesthesia (TIVA) with propofol (without a muscle relaxant and with intermittent intravenous fentanyl boluses) was used for the maintenance of anaesthesia guided by processed electroencephalography (EEG) using a bispectral index (BIS®) monitor. Regular spike artefacts were observed in the EEG signal recorded by the BIS® monitor during the application of the single-pulse transcranial electrical stimulus and were used as a visual indicator of stimulus delivery. Finally, we propose a novel method of confirming stimulus delivery during D-wave recording based on stimulation artefacts in the EEG signal recorded by the BIS® monitor.© 2022. The Author(s), under exclusive licence to Springer Nature B.V.

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